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Payment Details Amount Drawn on Bank Cheque / DD Number REGISTRATION FORM Name E-mail Phone Number City Qualifications Hospital / Institute Designation / Course Mode of Payment (Cheque / DD) MRCOG 2 & 3 Intensive Revision Course Course Fees ` 15,000/- Online Payment http://feepal.org/Online-Payment/coaching/Iirrh th Tuesday, 13 June 2017 8.30 AM - 6.00 PM Day 1 th Wednesday, 14 June 2017 8.00 AM - 6.00 PM Day 2 International Institute for Training and Research in Reproductive Health Payment by Cheque / DD can be made in favour of "IIRRH" and forwarded to the address below. IIRRH - No.7, East Park Road, Kumara Park East, Bangalore - 560 001. Mob: +91 78291 92444 Email: [email protected] Web: www.iirrh.org
